Can Wellbutrin Treat Mood Swings? (3+ studies are discussed)

This article focuses on using Wellbutrin (bupropion) for managing mood swings. Throughout this article, the scientific evidence surrounding the use of Wellbutrin for managing mood swings will be discussed, focusing on its potential benefits and risks.

The article will also address factors that influence Wellbutrin’s effect on mood swings, explore alternative treatment strategies, and discuss the importance of close monitoring and communication with healthcare professionals.

Can Wellbutrin treat mood swings?

Wellbutrin can help treat mood swings associated with depression, but it should not be used for this indication unless prescribed by a doctor. It is not approved by the FDA for the treatment of mood swings in people with mood disorders due to the risk of activation of manic, mixed, or hypomanic episodes [1].

Due to bupropion’s action -which increases norepinephrine and dopamine availability- and its unique pharmacokinetic properties, it has been suggested to have a lower risk of mood shifting than other antidepressants.

Some clinical studies state that it is effective for bipolar patients who have quick mood swings or don’t respond to standard therapy, especially when taken with lithium [2] [3].

However, the evidence supporting its use for bipolar depression is limited, and multiple studies suggest that it isn’t effective.

Moreover, there have been case reports of patients experiencing a switch to hypomania or mania while taking bupropion alone and with lithium, which casts doubt on its benefits in managing mood swings.

Mood swings and changed behavior are actually among bupropion’s side effects. It is also crucial to consider that certain individuals, especially those with bipolar disorder or mood disorders, may be at a higher risk for developing suicidal thoughts while taking Wellbutrin [1].

This emphasizes the importance of monitoring for changes in mood, behavior, or thoughts while taking Wellbutrin.

What does research say?

One study compared the risk of mood switches in patients with bipolar depression using different antidepressants with mood stabilizers.

It found that bupropion had a lower risk of causing mood switches into mania or hypomania compared to other antidepressants, favoring it as a preferred choice for treating bipolar depression [4].

Another study focused on severely ill bipolar depressive in-patients and observed positive results when using bupropion as a first-line antidepressant. Most patients experienced a significant reduction in symptoms without any switch to hypomania or mania [5].

However, there are 2 case reports of bipolar depression patients who experienced mood swings while taking bupropion, alone and in combination with lithium.

In addition, the case studies showed that Bipolar I disorder patients are at higher risk of antidepressant-related mood swings than BP II patients. This highlights the need for caution when using Wellbutrin to treat mood swings [6].

Finally, a meta-analysis reaffirmed the benefits of bupropion in treating bipolar depression, reporting that it is not more effective than other antidepressants. It also stated that the risk of mood swings with bupropion is not lower than with other antidepressants, contrary to earlier beliefs [7].

This highlights the importance for clinicians to be aware of the risk of mood changes when prescribing Wellbutrin to patients with mood disorders, regardless of the claimed possible benefits.

When can Wellbutrin be prescribed for mood swings?

In some cases, healthcare professionals may consider Wellbutrin as an off-label option for mood stabilization in bipolar depression.

The decision to use Wellbutrin for managing mood swings should be made by a healthcare professional, based on a thorough evaluation of the individual’s symptoms, overall condition, medical history, and clinical presentation.

Prescribing Wellbutrin as an adjunctive treatment for mood swings is usually only reserved for bipolar depressive patients who are unresponsive to standard treatment. This approach is supported by some scientific studies [2] [3].

Factors affecting Wellbutrin’s efficacy in managing mood swings

Multiple factors can impact the efficiency of Wellbutrin in managing mood swings. Some of these factors include:

Individual Differences

Each person has a unique biochemical makeup, which can affect how they respond to medication. Factors such as genetics, metabolism, and overall health can all influence the individual’s response to Wellbutrin.

Co-Occurring Conditions

Wellbutrin may be prescribed to manage mood swings in individuals with other underlying conditions such as anxiety or bipolar disorder. The presence of these co-occurring conditions may impact the overall effectiveness of Wellbutrin in managing mood swings.

Compliance

Like any medication, the effectiveness of Wellbutrin greatly depends on proper compliance and adherence to the prescribed dosage. Consistency in taking the medication as directed by the healthcare provider is essential for achieving optimal results.

Wellbutrin often requires time to build up in the body and exert its full beneficial effects. It may take several weeks or even months for individuals to experience the desired results. Thus, adherence to the prescribed duration of treatment is crucial for assessing its effectiveness.

Lifestyle factors and stress

Certain lifestyle factors, including diet, sleep patterns, and stress levels, can potentially influence the effectiveness of Wellbutrin. Maintaining a healthy lifestyle and managing stress can support the medication’s effectiveness in managing mood swings.

What to do if Wellbutrin is not helping your mood swings?

Medication adjustment

To manage mood swings while taking Wellbutrin, dose escalation is very important. Wellbutrin is typically initiated at a starting dose of 150 mg once daily. If well tolerated, the daily dose can be increased to 300 mg once daily after 4 or more days.

Moreover, depending on the nature of your mood swings, the healthcare professional may suggest reducing the dose of Wellbutrin. If the mood swings are severe, a gradual tapering approach followed by discontinuation may be recommended.

Addition of mood stabilizers

In some cases, adding a mood stabilizer to the treatment regimen can help mitigate mood swings experienced while taking Wellbutrin. Here are some examples of mood stabilizers:

• Lithium: Its recommended dose is 900 to 2400 mg per day, divided into two to three doses.
• Divalproex Sodium (Valproate): The recommended dose is 750 to 3000 mg daily, taken in divided doses.
• Lamotrigine: Its starting dose is 25 mg per day. The dose can be increased to 200 to 400 mg daily after two weeks, taken in divided doses.
• Carbamazepine: Its recommended dose is 400 to 1600 mg per day, also divided into multiple doses.

These drugs can be considered adjuncts to bupropion. The choice of mood stabilizer and its recommended dosage will depend on individual factors. It is essential to follow the healthcare professional’s guidance regarding the appropriate mood stabilizer and its dosage.

Close monitoring

While adjusting or introducing Wellbutrin treatment, close monitoring is essential. Regular follow-up visits with the healthcare professional will allow them to track the progress and make any necessary adjustments. Make sure to inform your doctor about any mood changes and side effects.

Lifestyle factors

Managing mood swings goes beyond medication adjustments. Taking care of your overall well-being can play a significant role in stabilizing your mood. Implementing healthy lifestyle practices such as adequate sleep and stress reduction techniques can support mood stability alongside medication adjustments.

Surrounding yourself with a support system can be beneficial. Engaging in therapy, or support groups, or seeking guidance from mental health professionals can provide valuable coping strategies and emotional support as you navigate the challenges of mood swings.

What are the alternatives to Wellbutrin for managing mood swings?

Several other antidepressants can be considered for managing mood swings. One option is Selective Serotonin Reuptake Inhibitors (SSRIs) such as Prozac (fluoxetine), Zoloft (sertraline), Celexa (citalopram), or Paxil (paroxetine). They increase the availability of serotonin in the brain, which can help stabilize mood.

Another option is Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) like Effexor (venlafaxine) or Cymbalta (duloxetine). SNRIs also increase serotonin levels, but they additionally target norepinephrine, which can enhance mood regulation.

Mood stabilizers like lithium, anti-convulsants (valproic acid and lamotrigine), and atypical antipsychotics (quetiapine) are also effective alternatives for managing mood swings. It’s important to note that these medications should be prescribed and adjusted by a healthcare professional based on individual needs, considerations, and potential side effects.

Conclusion

In conclusion, while Wellbutrin (bupropion) is primarily prescribed as an antidepressant, it may be considered an off-label option for managing mood swings in certain cases, such as bipolar depression. However, the evidence supporting its benefits in bipolar depression and mood stabilization is limited and mixed.

Prescribing Wellbutrin for mood swings should only be considered by healthcare professionals after a thorough evaluation of the individual’s symptoms and overall health. Close monitoring and regular follow-up visits are essential to track progress, evaluate side effects, and make any necessary adjustments to the treatment plan.

If mood swings occur while taking Wellbutrin, it is important to consult a healthcare professional who can assess the situation and suggest appropriate steps. Adjustments to the medication dosage, the addition of mood stabilizers, the use of alternative medications, and the incorporation of healthy lifestyle practices can be part of the management strategy.

References